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Dermatology Flashcards

1
Q

What is chondrodermatitis nodularis helicis?

A

Painful nodule on the ear

Benign

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2
Q

Management of chondrodermatitis nodularis helicis

A

Reduce pressure on the ear - foam ear protectors during sleep

cryotherapy, steroid injection, collagen injection

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3
Q

Causes of acanthosis nigricans

A 
T2DM
GI cancer
Obesity
PCOS
acromegaly
Cushing's disease
Hypothyroidism
Prader-Willi
Combined oral contraception
Nicotinic acid
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4
Q

What can be a consequence of long term antibiotic use in acne vulgaris?

A

gram negative folliculitis

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5
Q

Management of gram negative folliculitis

A

high dose oral trimethoprim

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6
Q

Why is minocycline no longer used for acne vulgaris?

A

irreversible pigmentation

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7
Q

What is the difference between scarring and non-scarring alopecia?

A

Scarring = destruction of hair follicle

Non-scarring = preservation of hair follicle

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8
Q

Causes of scarring alopecia

A 
trauma, burns
radiotherapy
lichen planus
discoid lupus
tinea capitis
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9
Q

Causes of non-scarring alopecia

A 
male-pattern baldness
iron and zinc deficiency
alopecia areata
telogen effluvium
trichotillomania
drugs
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10
Q

What drugs cause allopecia?

A 
cytotoxic drugs
carbimazole
heparin
oral contraceptive pill
colchicine
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11
Q

Cause of alopeia areata

A

Autoimmune hair loss

non-scarring

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12
Q

Features of alopecia areata

A

Demarcated patches of hair loss

“exclamation mark” hairs

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13
Q

Outcome of alopecia areata

A

50% patients regrow hair by 1 year

80-90% regrow hair eventually

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14
Q

Treatment for alopecia areata

A

Topical or intralesoinal steroids
Topical minoxidil
Phototherapy
Wigs

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15
Q

How do antihistamines work?

A

H1 inhibitors

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16
Q

Examples of sedating antihistamines

A

Chlorpheniramine

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17
Q

Non-sedating antihistamines

A

Loratidine

Cetirizine

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18
Q

Medical name for athlete’s foot

A

Tinea pedis

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19
Q

Management of athlete’s foot

A

Topical imidazole

Topical terbinafine

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20
Q

How does atopic eruption of pregnancy present?

A

Ecematous, itchy, red rash

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21
Q

What is the commonest skin disorder in pregnancy?

A

Atopic eruption of pregnancy

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22
Q

What is melasma?

A

Hyperpigmented macules in sun exposed areas

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23
Q

Causes of melasma

A

Pregnancy

combined oral contraceptive pill

hormone replacement therapy

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24
Q

What are milia?

A

Small benign keratin filled cysts typically found on the face

More common in newborns

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25
What are salmon patches?
Pink, blotchy vascular birthmark on new borns Fade over a few months
26
Management of periorificial dermatitis
topical or oral antibiotics
27
Nail changes seen in psoriasis
Pitting Oncholysis Subungual hyperkeratosis Loss of the nail
28
What is a keratoacanthoma?
Benign epithelial tumour
29
Features of a keratoacanthoma
Look like a volcano or crater Initially smooth dome shaped papule Becomes crater centrally filled with keratin
30
Management of keratoacanthoma
Urgent excision as difficult to differentiate clinically from SCC
31
What is granuloma annulare?
Papular lesion slightly pigmented and depressed centrally Found on dorsal of hand and feet
32
Management options for hyperhidrosis
1st line = Topical aluminium chloride Iontophoresis Botox Surgery e.g. endoscopic transthoracic sympathectomy
33
Causes of onycholysis
``` Trauma Infection - esp fungal Psoriasis, dermatitis Raynaud's Hyper and hypo thyroidism ```
34
How to diagnosis nickel dermatitis?
Skin patch test
35
Vaccination against primary varicella
Live attenuated vaccine For healthcare workers who are not already immune and contacts of immunocompromised patients
36
Shingles vaccine What type of vaccine is it? Who gets it?
Live attenuated, sub cut Patients age 70-79
37
Management of leukoplakia
Biopsy to exclude squamous cell carcinoma Regular follow up to check for malignant transformation
38
When are systemic side effects seen from potent topical steroids?
Applied to >10% body surface areas
39
How long to use potent steroids for?
8 weeks
40
How long to use very potent steroids for?
4 weeks
41
Side effects of topical steroids
Skin atrophy Striae Rebound symptoms
42
Can vitamin D analogues be used long term?
Yes
43
Effect of vitamin D on the psoriasis plaque
Reduce scale and thickness but not the erythema
44
Can you use vitamin D analogues for psoriasis in pregnancy?
no
45
Side effects of dithranol used in psoriasis
Burning | Staining
46
Side effects of phototherapy
Ageing | Squamous cell skin cancer
47
Phototherapy for psoriasis
narrow band UVB photochemotherapy= psoralen + ultraviolet A light (PUVA)
48
Psoriasis - criteria for non-biological systemic therapy
- Can't be controlled with topical therapy - Significant impact on wellbeing + ONE OF: - Psoriasis is extensive - Localised with significant functional impairment/distress - Phototherapy ineffective
49
First line systemic therapy agent for psoriasis
Methotrexate
50
When is ciclosporin used over methotrexate in psoriasis?
Rapid or short term disease control Palmoplantar pustulosis Considering conception (men and women)
51
Second line systemic therapy agent for psoriasis
ciclosporin
52
Criteria for biological therapy in psoriasis
Failed trial of methotrexate, ciclosproin and PUVA
53
Effectiveness of oral retinoids for acne
2/3 have long term remission or cure
54
Side effects of oral retinoids
``` Teratogen Dry skin, eyes, lips/mouth Low mood Raised triglycerides Hair thinning Nose bleeds Intracranial hypertension Photosensitivity ```
55
What is the most common side effect of oral retinoids?
Dry skin, eyes, lips and mouth
56
Why should you not combine oral retinoids with tetracyclines?
both increase the risk of intracranial hypertension
57
Causes of erythema nodosum
``` Infection = strep, TB Sarcoidosis IBD Behcet's Malignancy/lymphoma Drugs = penicillin, sulphonamides, contraceptive pill Pregnancy ```
58
Drug causes of urticaria
Aspirin Penicillins NSAIDs Opiates
59
Management of urticaria
Non-sedating antihistamines Prednisolone in severe or resistent cases
60
Which is the most common type of contact dermatitis?
Irritant contact
61
Irritant contact dermatitis - causes
Detergents | Cement
62
Irritant contact dermatitis - presentation
On the hands Erythema typical Crusting/vesicles rare
63
Allergic contact dermatitis - causes
Hair dyes
64
Allergic contact dermatitis - presentaiton
Acute weeping eczema
65
Which type of skin cancer tends to be found in scar tissue?
Squamous cell carcinoma
66
Spider naevi associations
Liver disease Pregnancy Combined oral contraceptive pill
67
Polymorphic eruption of pregnancy - features
Generally third trimester Pruritic eruption Lesions in abdominal striae
68
Polymorphic eruption of pregnancy - management
Emollients Mild potency topical steroids Oral steroids
69
Pemphigoid gestationis - features
Pruritic blistering lesions Peri-umbilical region then spreading 2nd and 3rd trimester
70
Pemphigoid gestationis - management
oral corticosteroids
71
What is hirsutism?
Androgen dependent hair growth in women
72
What is hypertrichosis?
Androgen independent hair growth
73
Causes of hirsutism
``` PCOS Cushing's Congential adrenal hyperplasia Androgen therapy Obesity Adrenal tumour Androgen secreting ovarian tumour Phenytoin Corticosteroids ```
74
Most common cause of hirsutism
PCOS
75
How is hirsutism assessed?
Ferriman-Gallwey scoring system
76
Management of hirsutism
Weight loss Cosmetic techniques waxing/bleaching Oral contraceptive pill For facial hirsutism - topical eflornithine
77
Causes of hypertrichosis
Drugs = minoxidil, ciclosporin, diazoxide Congenital Porphyria cutanea tarda Anorexia nervosa
78
Cause of eczema herpeticum
Herpes simplex 1 or 2
79
Management of eczema herpeticum
Admit for IV aciclovir
80
Which burns to refer to secondary care?
Deep and full thickness Superficial burns >3% TBSA in adults or 2% in children Superficial burns involving face hands perineum genitals or any flexure Circumferential burns Inhalation injury Electrical or chemical burn Suspicion of non-accidental injury
81
Features of discoid eczema
Round or oval plaques Extremely itchy On the extremities
82
What is 1 finger tip unit?
0.5g Sufficient to treat a skin area about twice that of a flat adult hand
83
Example of a mild potency steroid
Hydrocortisone 0.5-2.5%
84
Example of a moderate potency steroid
Betamethasone valerate 0.025% (betnovate RD) Clobetasone butyrate 0.05% (eumovate)
85
Example of a potent steorid
Fluticasone propionate 0.05% (cutivate) Betametasone valerate 0.1% (betnovate) Betametasone dipropionate 0.05% (diprosone)
86
Example of a very potent steroid
Clobetasone proprionate 0.05% (dermovate)
87
Treatment of a plantar wart
Salicyclic acid 1-50% applied daily for 12 weeks
88
What is first line contraception for management of acne?
Microgynon
89
What is second line contraception for management of acne?
Dianette Don't continue once acne controlled for 3 months
90
Drugs that exacerbate psoriasis
``` Beta blockers Lithium Antimalarials NSAIDs ACE-I infliximab ```
91
What is a venous lake?
Angioma on the lip No treatment needed unless wanted for cosmetic reasons
92
Skin disorders associated with SLE
Photosensitive 'butterfly' rash Discoid lupus Alopecia Livedo recitularis
93
Investigations for allergic contact dermatitis
Patch testing
94
Causes of skin bullae
``` Epidermolysis bullosa (congenital) Bullous pemphigoid Pemphigus Insect bite Trauma/friction Furosemide Barbiturates ```
95
What is dermatitis artefacta?
Self inflicted skin lesions, patients deny that they are self induced
96
Features of dermatitis artefacta
Linear/geometric depending on cause E.g. scratching, deodorant spray, inhaler Appear suddenly Commonly face or hands Patients are non-chalant "la belle indifference"
97
What causes the itching in scabies?
Delayed type IV hypersensitivity reaction to mites laying eggs 30 days after initial infection
98
Scabies - features
Widespread pruritis Linear burrows In infants - face and scalp
99
1st line management for scabies
Permethrin 5%
100
2nd line management for scabies
Malathion 0.5%
101
Directions to give to patients about applying scabies treatment
Apply to all areas Allow to dry for 8-12 hours for permethrin or 24 hours for malathion, then wash off Repeat after 7 days All of household treated
102
How long does pruritis last in scabies?
4-6 weeks after treatment
103
Causes of erythroderma
``` Eczema Psoriasis Drugs - e.g. gold Lymphoma, leukaemia Idiopathic ```
104
Drug causes of lichen planus
Gold Quinine Thiazides
105
Lichen planus - features
Itchy, papular rash "white lines" pattern on surface Koebner phenomena Oral involvement in 50%
106
What is koebner phenomena?
new lesions at site of trauma
107
What is vitiligo?
Autoimmune condition leading to loss of melanocytes and depigmentation of the skin
108
Vitiligo - associated conditions
``` T1DM Addison's disease Autoimmune thyroid disorders Pernicious anaemia Alopecia areata ```
109
Vitiligo - features
Well demarcated patches of depigmented skin Peripheries most affected Koebner phenomena
110
Vitiligo - management
Sunblock Camoflague make up Topical steroids may reverse changes if applied early
111
Main cause of fungal nail infection
Dermatophytes - trichophyton rubrun in 90% of cases
112
Causes of fungal nail infection
1) Dermatophytes - trichophyton rubrun in 90% of cases | 2) Yeasts - candida
113
Treatment of candida fungal nail infections
Topical antifungal if mild | oral itraconazole for 12 months
114
Treatment of dermatophyte fungal nail infection
Oral terbinafine Up to 3 months Successful in 50-80%
115
What causes seborrhoeic dermatitis?
Inflammatory reaction to malassezie furfur
116
Seborrhoeic dermatitis - associated conditions
HIV | Parkinson's disease
117
Seborrhoeic dermatitis - 1st line management of scalp disease
Head and shoulders | Tar
118
Seborrhoeic dermatitis - 2nd line management of scalp disease
ketoconazole
119
Seborrhoeic dermatitis - management of face and body disease
Topical antifungals - ketoconazole | Topical steroids
120
Seborrhoeic dermatitis in children - management
Baby shampoo and oils | Mild topical steroids 1% hydrocort
121
Seborrhoeic dermatitis in children - presentation
Craddle cap | Resolves spontaneously by 8 months
122
What worsens psoriasis?
``` Skin trauma Stress Streptococcoal infection Alcohol Withdrawing steroids Drugs ```
123
What drugs worsen psoriasis?
``` Beta blockers Lithium Antimalarials NSAIDS ACEI Infliximab ```
124
1st line management of psoriasis
Potent corticosteroids OD + vitamin D analogue OD for up to 4 weeks
125
2nd line management of psoriasis
Vitamin D analogue BD
126
3rd line management of psoriasis
Potent corticosteroids BD for up to 4 weeks OR coal tar
127
Examples of vitamin D analogues
Calcipotriol Calcitriol Tacalcitol
128
1st line management of scalp psoriasis
Potential topical corticosteroid for 4 weeks
129
2nd line management of scalp psoriasis
Different formulation of steroid + topical agent to remove scale (eg. salicylic acid) before applying steroid
130
Management of face/flexural/genital psoriasis
Mild/mod steroid OD/BD for 2 weeks
131
Phototherapy options for managing psoriasis
Narrow band UVB Psorlaen + UVA (PUVA)
132
Systemic therapy options for managing psoriasis
Oral methotrexate Ciclosporin Systemic retinoids Infliximab
133
What triggers guttate psoriasis?
Strep
134
Features of pityriasis rosea
Herald patch on trunk | THEN erythematous, oval, scaly patches which follow characteristic distribution "fir tree appearance"
135
Management of pityriasis rosea
Self limiting | Resolves in 6-12 weeks
136
Treatment for tinea corpis
oral fluconazole
137
Presentation of tinea capitis
Scarring alopecia | Untreated may cause kerion (raised, pustular, boggy mass)
138
Management of tinea capitis
``` Oral antifungals (terbinafine or griseofulvin) Topical ketoconazole ```
139
What is bullous pemphigoid?
Autoimmune condition causing sub-epidermal blistering
140
Features of bullous pemphigoid
Elderly patients Itchy, intense blisters around flexures Blisters heal without scarring No mucosal involvement
141
Management of bullous pemphigoid
Oral steroids Topical steroids Immunosuppression Antibiotics
142
What is pemphigus vulgaris?
Autoimmune disease causing skin blistering and mucosal ulceration
143
Features of pemphigus vulgaris
Mucosal ulceration Skin blistering - flaccid, easily ruptured Lesions painful but not itchy Nikolsky's sign
144
Management of pemphigus vulgaris
steroids | immunosuppression
145
School exclusion in molluscum contagiosum?
Not needed
146
Management of molluscum contagiosum
Advise not to share towels, clothing or baths Will self-resolve within 18 months Can try to squeeze/pierce lesions Cryotherapy
147
Molluscum contagiosum - who to refer?
HIV positive and extensive lesions Eyelid margin or ocular lesion Adults with anogenital lesions for STI screening
148
What is pityriasis versicolour?
Superficial cutaneous infection caused by malassezia furfur
149
Features of pityriasis versicolour
``` On trunk Patches may be hypopigmented, pink or brown May be more noticeable with suntan Scale is common Mild pruritis ```
150
Management of pityriasis versicolour
Ketoconazole shampoo If doesn't respond then send skin scrapings to confirm diagnosis and oral itraconazole
151
Pyogenic granuloma - features
Initially red/brown spot Rapid progression to raised, spherical lesion Lesions may bleed profusely or ulcerate
152
Pyogenic granuloma - management
Lesions associated with pregnancy resolve after pregnancy Curettage + cauterisation Cryotherapy Excision
153
Pyoderma gangrenosum - causes
``` IBD RA SLE Myeloproliferative disorders, lymphoma, leukaemia Primary biliary cirrhosis ```
154
Pyoderma gangrenosum - features
``` Lower limbs Initially small red papule Becomes a deep red necrotic ulcer Ulcer has violaceous border May have systemic features ```
155
Pyoderma gangrenosum - management
High risk of rapid progression 1st line: oral steroids 2nd line: other immunosuppressants e.g. ciclosporin, infliximab
156
What is pompholyx?
Type of eczema that affects hands and feet
157
Pompholyx - presentation
Blisters on palms and soles Intensely itchy Blisters may burst to become dry, cracked ski
158
Pompholyx - management
Cool compresses Emollients Topical steroids
159
Porphyria cutanea tarda - features
Photosensitive rash with blistering Skin fragility Hypertrichosis Hyperpigmentation
160
Porphyria cutanea tarda - management
Chloroquine | Venesection if ferritin >600
161
Management of shingles
Analgesia - simple, then amitriptylline, then steroids if severe pain in first 2 weeks Antivirals - within 72h unless <50y with mild rash only, reduces post hepatic neuralgia
162
Drugs that cause Stevens-Johnson Syndrome
``` Penicillin Sulphonamides Lamotrigine, carbamazepine, phenytoin Allopurinol NSAIDS Oral contraceptive pill ```
163
Features of Stevens-Johnson Syndrome
Maculopapular rash with vesicles and bulae Mucosal involvement Systemically unwell with fever and arthralgia
164
Drugs that cause of Toxic Epidermal Necrosis
``` Phenytoin Sulphonamides Allopurinol Penicillins Carbamazepine NSAIDS ```
165
Features of Toxic Epidermal Necrosis
Blistering and peeling of the skin Mucosal involvement Systemically unwell (very) Positive Nikolsyk's sign
166
Who gets Zoon's balanitis?
Uncircumcised middle aged/elderly men
167
Features of Zoon's balanitis
Erythematous, well demarcated shiny patches which affect head of the penis
168
Zoon's balanitis management
Circumcision is curative
169
Rosacea - features
``` Flushing Telangiectasis Persistent erythema with papules and pustules Sunlight exacerbates symptoms Rhinophyma ```
170
Rosacea - 1st line management
Topical metronidazole
171
Rosea - 2nd line management
Oral oxytetracycline
172
What is dermatitis herpetiformis?
Autoimmune blistering condition associated with coeliac's disease
173
Management of dermatitis herpetiformis
Gluten free diet | Dapsone
174
Features of erythema multiforme
Target lesions
175
Causes of erythema multiforme
``` Herpes simplex Orf Mycoplasma, streptococcus SLE Sarcoidosis Malignancy Drugs - penicillin, carbamazepine, allopurinol, NSAIDS, oral contraceptive ```
176
What is erythema multiforme major?
Severe form with mucosal involvement
177
What is acral lentiginosus?
Rare malignant melanoma form Nails, palms, soles Seen in Asians and African Americans
178
What is lentigo maligna?
Less common malignant melanoma Seen in chronically sun exposed older people A growing mold
179
Most common type of malignant melanoma?
Superficial spreading
180
Diagnostic features for melanoma - major features
Change in size Change in shape Change in colour
181
Diagnostic features in malignant melanoma - minor features
Diameter >7mm Inflammation Oozing and bleeding Altered sensation
182
Malignant melanoma - what determines prognosis?
Breslow depth
183
Squamous cell carcinoma - risk factors
``` Excessive sunlight UVA phototherapy Actinic keratoses and Bowen's disease Immunosuppression Smoking Long standing leg ulcers ```
184
Squamous cell carcinoma - management
Surgical excission
185
Squamous cell carcinoma - good prognostic factors
Well differentiated tumours <20mm diameter <2mm depth No associated diseases
186
Squamous cell carcinoma - poor prognostic factors
Poorly differentiated tumours >20mm diameter >4mm depth Immunosuppression
187
What is Bowen's disease?
Pre-cancerous skin lesion Percursor to SCC 10% change of cancer if left untreated
188
Features of Bowen's disease
Red, scaly patches on sun exposed sites
189
Management of Bowen's disease
Topical 5-fluorouracil (use topical steroids if significant inflammation) Cyrotherapy Excision
190
Features of basal cell carcinoma
"rodent ulcers" Pearly flesh coloured papules with tenalgiectasis Ulcerate causing central crater
191
Management of basal cell carcinoma
Surgical removal Curettage Cyrotherapy
192
Referral timeline for basal cell carcinoma
Routine
193
Referral timeline for squamous cell carcinoma
Urgent
194
What is actinic keratoses?
Premalignant skin changes
195
Actinic keratoses - features
Small, crusty or scaly lesions Pink, red, brown or skin colour Sun exposed sites May have multiple
196
Actinic keratoses - management
Fluorouracil cream (steroids if skin becomes very inflammed) Topical diclofenac if mild Topical imiquimod Cryotherapy
197
Bacteria seen in acne
Propionibacterium acnes
198
What percentage of adolescents get acne?
80-90% | 60% seek advice
199
What percentage of adults get acne?
10-15% women over 25 | 5% men over 25
200
Management of acne vulgaris - step 1
Single topical therapy - topical retinoids or benzyl peroxide
201
Management of acne vulgaris - step 2
Topical antibiotic + topical retinoid or benzyl peroxide
202
Management of acne vulgaris - step 3
Oral antibiotic PLUS topical retinoid or benzyl peroxide - lymecycline, doxycycline - erythromycin in pregnancy OR try oral contraceptive in women
203
Management of acne vulgaris - step 4
Oral isotretinoin
204
Superficial epidermal burn appearance
Red and painful
205
Partial thickness (superficial dermal) burn appearance
Pale pink, painful, blistered
206
Partial thickness (deep dermal) burn appearance
Typically white, may have patches of non-blanching erythema, reduced sensation
207
Full thickness burn appearance
White/brown/black No blisters No pain
208
Which oral contraceptive to prescribe women to treat acne?
Dianette (co-cyrindiol)
209
Which of bullous pemphigoid and pemphigus vulgaris has mucosal involvement?
Pemphigus vulgaris
210
What is erythrasma? How is it treated?
Flat, slightly scaly pink or brown rash in the groin or axillae Treat with topical micondazole or antibiotic
211
Lichen sclerosus - presentation
White plaques on dermis Genitalia Very itchy
212
Lichen sclerosus - management
Topical steroids and emollients
213
Management of oral lichen planus
Benzydamine mouthwash
214
Common sites for keloid scars in order
1) sternum 2) shoulder 3) neck 4) face 5) extensor surface of limbs 6) trunk
215
Treatment of keloid scars
Early - intra-lesional steroids | Excision
216
What does a tight white ring around tip of foreskin and phimosis suggest?
Lichen sclerosis
217
Which antibiotic should not be co-prescribed with oral isotretinoin?
Tetracyclines due to risk of benign intracranial hypertension
218
What is oral linchen planus called?
Wickham's striae
219
What is granuloma inguinale (donovanosis)?
STI caused by klebsiella granulomatosis
220
When to suspect granuloma inguinale (donovanosis)?
Enlarging ulcer that bleeds in the inguinal area
221
What is the risk with erythma ab igne?
Untreated may cause squamous cell cancer
222
Treatment of strawberry naevus
Not normally needed as 95% resolve by age 10 Propranolol
223
What is keratoderma blenorrhagica?
Waxy yellow/brown papules on palms and soles
224
How many fingertip units needed for hand and fingers?
1
225
How many fingertip units needed for a foot?
2
226
How many fingertip units needed for front of chest and abdomen
7
227
How many fingertip units needed for back and buttocks
7
228
How many fingertip units needed for face and neck
2.5
229
How many fingertip units needed for entire arm and hand
4
230
How many fingertip units needed for entire leg and foot
8
231
What is a fingertip unit?
0.5g Enough to treat a skin area about twice that of a flat of an adult hand
232
Management of venous ulcers
Compression bandaging Oral pentoxifylline, a peripheral vasodilator
233
ABPI >1.2
Calcified, stiff arteries | Seen in advanced age or PAD
234
ABPI 1.0-1.2
Normal
235
ABPI 0.9-1.0
Acceptable
236
ABPI <0.9
Likely PAD
237
ABPI <0.5
Severe PAD, refer urgently
238
At what ABPI is compression bandaging considered acceptable?
ABPI ≥ 0.8
239
Best first line management for tinea capitis
Oral terbinafine with topical ketoconazole shampoo for the first 2 weeks
240
When should a patient with guttate psoriasis be urgently referred for phototherapy?
if >10% of body surface area affected
241
What is notalgia paraesthetica?
Chronic itch on medial border of scapula
242
Atopic eruption of pregnancy
Eczematous, itchy red rash | No specific treatment needed
243
Polymorphic eruption of pregnancy
Pruritic condition in the 3rd trimester Lesions in abdominal striae Management = emollients, mild potency topical steroids, oral steroids
244
Pemphigoid gestationis
Pruritic blistering lesions Often in peri-umbilical region before spreading Rarely in first pregnancy Needs oral steroids
245
Skin disorders in SLE
Photosensitivity butterfly rash Discoid lupus Alopecia Livedo reticularis
246
What is juvenile spring eruption?
Itchy red rash of small bumps on tops of ears after sun exposure
247
Management of juvenile spring eruption
Suncream, hats Emollients Calamine lotion Antihistamines In severe cases with painful blisters and crusts may need oral steroids or immunosuppression (should do ANA and ENA to rule out lupus)
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Causes of impetigo
staphylococcus aureus Streptococcus pyogenes
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Impetigo - management of local disease
1st: 1% hydrogen peroxide 2nd: topical fusidic acid 3rd: topical mupirocin if MRSA
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Impetigo - management in extensive disease
Oral flucloxacillin Oral erythromycin if penicillin allergic
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Management of hidradenitis suppurativa acute flares
Oral/intralesional steroids Flucloxacillin I+D
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Management of hidradenitis suppurativa long term disease
Topical clindamycin Oral lymecycline/clindamycin/rifampicin
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What factors predispose to developing pressure ulcers?
Malnourishment Incontinence Lack of mobility Pain
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Which scoring system is used to identify patients at risk of pressure ulcers?
Waterlow score
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What is grade 1 pressure score?
Non-blanching erythema | Skin is intact
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What is a grade 2 pressure sore?
Partial thickness skin loss involving epidermis or dermis or both Ulcer is superficial
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What is a grade 3 pressure sore?
Full thickness skin loss involving damage to or necrosis of subcutaneous tissue that may extend down to underlying fascia
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What is a grade 4 pressure sore?
Extensive destruction, tissue necrosis | Damage to muscle or bone

AKT (20 decks)

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